A Smartphone-Based Pilot HIV Prevention Intervention (<i>Sakhi</i>) among Transgender Women Who Engage in Sex Work in India: Efficacy of a Pre- and Post-Test Quasi-Experimental Trial

Abstract

Transgender women (TGW) in India, especially those who engage in sex work, are at high risk for HIV. Guided by the information-motivation-behavioral skills model and qualitative formative research findings, Sakhi (girlfriend), a 3-week smartphone-based pilot intervention consisting of short videos (one/week) and text messages (two/week), was implemented using a one-group pre- and post-test design to test its efficacy in promoting condom use and HIV testing among TGW (n = 50) who engage in sex work in Chennai. Changes in outcomes were assessed by conducting multivariable analyses using generalized estimating equations. Participants’ mean age was 26 years, and the mean monthly income was INR 21700 (USD 292). About one-third completed college, and 96% were HIV-negative. Significant changes in the desired direction were observed in the primary outcomes: condom use – decrease in the engagement of condomless anal sex with male partners (12% to 2%, p p Sakhi intervention and warrants a larger randomized trial among diverse subgroups in diverse settings.

Keywords

• condom use
• HIV testing
• mental health
• e-health
• m-health
• outcome evaluation